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Greater remission rates in patients with early versus long-standing disease in biologic-naive rheumatoid arthritis patients treated with abatacept: a post hoc analysis of randomized clinical trial data.

AbstractOBJECTIVES:
Current aim of rheumatoid arthritis (RA) treatment is to achieve remission in as many patients as possible. Rates of remission and clinical outcomes after treatment with abatacept in biologic-naive rheumatoid arthritis (RA) patients with early disease and an inadequate response to methotrexate (MTX) versus patients with ≥ 10 years of disease were assessed.
METHODS:
Data from two trials assessing the efficacy of abatacept in MTX inadequate responders were pooled for this exploratory post hoc analysis. Patients with disease duration of ≤ 2 years at baseline (early disease), originally assigned to an abatacept approximately 10 mg/kg treatment arm and entered into a long-term extension (LTE), were compared with patients with ≥ 10 years of disease (long-standing RA). Remission, DAS28-CRP, ACR 70 responses and the Routine Assessment of Patient Index Data 3 (RAPID3), improvement in physical function as measured by the Health Assessment Questionnaire Disability Index (HAQ-DI).
RESULTS:
Twenty-three percent of these patients (n=108) had early disease. A higher percentage of patients with early disease achieved DAS28-CRP remission versus patients with long-standing disease (35.2% vs. 19.4% at year 1, p<0.01; 46.0% vs. 30.9% at year 3, p<0.05). In addition, a higher percentage of the subgroup with early RA achieved ACR70 responses. More patients with early RA had a meaningful improvement in their HAQ-DI (75.2% vs. 60.4%; p<0.05) and RAPID3 scores at one year (mean changes from baseline of -9.6 vs. -8.1; p=0.009).
CONCLUSIONS:
These data provide additional support for the possible use of abatacept in biologic-naive patients who have had inadequate response to MTX, earlier in their disease course.
AuthorsY Yazici, D Moniz Reed, C Klem, L Rosenblatt, G Wu, J M Kremer
JournalClinical and experimental rheumatology (Clin Exp Rheumatol) 2011 May-Jun Vol. 29 Issue 3 Pg. 494-9 ISSN: 0392-856X [Print] Italy
PMID21722499 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antirheumatic Agents
  • Immunoconjugates
  • Tumor Necrosis Factor-alpha
  • Abatacept
  • Methotrexate
Topics
  • Abatacept
  • Adult
  • Aged
  • Antirheumatic Agents (therapeutic use)
  • Arthritis, Rheumatoid (drug therapy)
  • Disability Evaluation
  • Double-Blind Method
  • Female
  • Humans
  • Immunoconjugates (therapeutic use)
  • Longitudinal Studies
  • Male
  • Methotrexate (therapeutic use)
  • Middle Aged
  • Remission Induction
  • Time Factors
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha (antagonists & inhibitors)

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